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Donaldson, himself a survivor of melanoma, has been moderating the NCCN panels since 2006, an opening day session that has come to be one of the highlights of the meeting in South Florida, which typically draws some 1,000 health care professionals.

This year, Donaldson challenged the panel to come up with one thing that the corporate world could accomplish or would want to accomplish that could improve outcomes for employees with cancer.

“I don't think there is one particular thing we want,” said J. Randall MacDonald, IBM's Senior Vice President for Human Resources. “From the IBM perspective, I think we are pretty comfortable where we are. What we are uncomfortable with is where we are going.”

MacDonald said that questions raised in the 90-minute panel discussion regarding how various health benefits dealt with reimbursement for patients entering clinical trials was one area that was murky. “I think it is something that we have to progressively think about,” he said.

Advance Directives

J. Brent Pawlecki, MD, Chief Health Officer for Goodyear Tire and Rubber Company, emphasized the importance of advance directives: “As an employer, I think the number one thing we would want is to have employees and doctors begin discussions on advance directives with family members,” and then also be aware of where wills and advance directive are located so that these vital documents could be accessed quickly when needed.

Also in the discussion, Sheri McCoy, MSc, MBA, Vice Chairman of Johnson & Johnson's Executive Committee, said, “Corporate America should focus more on how to educate their employees and families about how to care for themselves and make sure they are creating environments that are healthy for them to work in every day.”

Expert Second Opinions

Helen Darling, President and CEO of the National Business Group of Health, said that corporations should make sure that all cancer patients are aware that their condition requires expert assessment: “No matter what diagnosis they have or how healthy or unhealthy they are, they should have a second opinion,” she said, adding that the corporation or its health insurer should pay for second opinions at top centers of excellence, including travel to that center if necessary.

“The biggest problem we see is that people are not getting the right diagnosis at the right time or the right treatment. We are not only wasting money, but we lose the opportunity to get the right treatment.” In addition, she said, corporations should make sure that their employee-patients are able to navigate the health care system.

Added Kavita Patel, MD, a Managing Director at the Brookings Institution's Engelberg Center for Health Care Reform: “Corporate America should make sure than every single one of their employees knows how to find a high-quality primary care doctor or clinician in their area to give them the information they need. That's the best thing they can go to solve all the problems we have discussed today.”

Education

Also on the panel, Carole Klase, PhD, a mental health educator and former speech writer, and whose one-year anniversary of a diagnosis of Merkel cell carcinoma will be in early June, agreed that education of the patient and the patient's caregiver is vital: “Families should be educated. There should be a designated caregiver. We must have someone educated—someone to help us in the case of a catastrophic thing happening. None of us think it would ever happen, but it can, and it is very, very important for companies to take an interest and talk to people at moment the person is diagnosed.”

Backup and Support

Corporations should make sure that employees have backup plans, with an emphasis on a person's caregiver whether that person is another family member or a friend, she said. “I watch people come to Johns Hopkins [where she was treated, at Sidney Kimmel Comprehensive Cancer Center there], have a 10-hour operation, and leave by themselves. I think that is terrifically tragic….We have a lot of technology. We don't make a lot of personal connections.”

Another cancer survivor, of lymphoma, John Greene, Director of Engineering for San Francisco-based Salesforce.com, emphasized the importance of help groups—”they were amazing for me”—as well as providing matching funds for donations: “At Salesforce, everyone can donate up to $1,000 to non-profits, and we will match it. Weaving that philanthropy into the fabric of what you do every day can go a long way.”

Also on the panel, Robert W. Carlson, MD, Professor of Medicine at Stanford University Medical Center, said, “Corporate American could do a number of things to facilitate the care of their employees with cancer, but if I have to focus it down to a single specific issue, I'd say we need to be sure that the system is configured so that employees with cancer fight the cancer and don't have to waste time fighting their insurance companies.”

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